Mpelling IndicationInitial Therapy OptionsHeart failureTHIAZ, BB, ACEI, ARB, ALDO ANTPost myocardial infarctionBB, ACEI, ALDOANTHigh CVDriskTHIAZ, BB, ACEI, CCBDiabetesTHIAZ, BB, ACEI, ARB, CCBChronic kidney diseaseACEI, ARBRecurrent stroke preventionTHIAZ, ACEICompelling indications for Individual Drug Classesy:THIAZ = thiazide diuretic, ACEI= angiotensin converting enzyme inhibitor, ARB = angiotensin receptor blocker, BB = beta blocker, CCB = calcium channel blocker, ALDO ANT= aldosterone antagonistBlood Pressure Measurement TechniquesMethodNoteso readings, 5 minutes apart, sitting in chair.Provides information on response to therapy.May help improve adherence to therapy and isthe NHLBI Web site at http://www.nhlbi.nih.govor from the NHLBI Health Information Center, P.O.Box30105, Bethesda, MD20824-0105; Phone: 301-592-8573 or 240-629-3255 (TTY); Fax: 301-592-8563.eating plan, dietary sodium reduction, aerobic physical activity, and rinciples of Lifestyle ModificationAdoptadiet rich in fruits, um or 6 g sodium chloride).30minutes per day, most daysof the week.2 drinks* per day.1 drink* per day.* 1 drink = 1/2 oz or 15 mLethanol (e.g., 12 oz beer, 5oz wine, 1.5 oz 80-proof whiskey).
Effects are dose and time dependent.Clinician empathy increases patient trust, motivation, and adherence to therapy.in formulating therapy
.rategies for Improving Adherence to TherapyOver-the-counter (OTC) drugs and herbal supplementsuses of Resistant HypertensionLifestyle Modification .SBPReduction RangeU.S.DEPARTMENT OF HEALTH AND HUMAN SERVICESNational High Blood Pressure Education ProgramNIHPublication No.03-5231Algorithm for Treatment of Hypertensioneference Card From the Seventh Report of the Joint National Committee on PrDetection, Evaluation, and Treatment of High Blood Pressure (JNC7)EVALUATIONClassification of Blood Pressure (, Stage 1140159or9099 160or30 kg/m2)Diabetes mellitusCigarette smokingPhysical inactivityMicroalbuminuria, estimatedAge (55 for men, 65 for women)Family history of premature CVDAssess for Major Cardiovascular Disease (CVD)Risk FactorsCushings syndrome or steroidAssess for Identifiable Causes of HypertensionTREATMENTLifestyle ModificationsNot at Goal Blood Pressure (130/80 mmHg for patients with diabetes or chronic kidney disease)ategies for Improving Adherence to TherapyInitial Drug ChoicesWithout CompellingIndicationsith CompellingNot at Goal Blood Pressurerinciples of Hypertension TreatmentHypertension(SBP160 or DBPtype diuretic and ACEI,or ARB, or BB, or CCB).Other antihypertensivedrugs (diuretics, ACEI,Optimize dosages or add additional drugs until goal blood pressure isachieved.Consider consultation with hypertension specialist.ategies for Improving Adherence to TherapyBlood Pressure Measurement Techniques(reverse side)ey: SBP= systolic blood pressure
DBP= diastolic blood pressureU.S.
DEPARTMENT OF HEALTH AND HUMAN SERVICES.
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